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DATE RECEIVED_ - EHD LOG NUMBER <br />SANJOAQUIN CC99 °N,Ati SI0Z ti 'un ,, Sohl panlaaad <br />ENVIRONMENTAL. HEALTH DEPARTMENT <br />JJUN4 — 1r- 1868 East Hazelton Avenue, Stockton, CA 95205-6232 5 <br />Z0f.� Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />PVT— <br />APPLICANT: Jessica Gonzalez <br />BUSINESSIAGENCY: AEI Consultants <br />ADDRESS: 2500 Camino Diablo CITY/STATE/ZIP: Walnut Creek, CA 94597 <br />PHONE (1): 925-746-6050 PHONE (2): 510.688-0981 FACSIMILE: 925-746-6099 <br />TENTATIVE` APPOINTMENT DATE: Please call Time: <br />(PI®ase allow 10 buuiness daps from date of application submittal - "Tenrat/ve only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />DATE <br />Electronic Information: ❑ List ® Map — Description: <br />Street # <br />FILE ADDRESS <br />EHD USE ONLY <br />�ra �j�U �' e°�' �� �, ❑Unit 1 <br />/ jj=t= 1 <br />:L, r^ D unit 2 <br />-- <br />1. <br />Street Name <br />... ,_ <br />E Citation <br />City <br />1621 <br />— <br />Stockton (unincorporated) <br />2. <br />1641 <br />E Citation <br />C E Dixon Street <br />Stockton (unincorporated) <br />3. <br />6755 <br />Stockton (unincorporated) <br />r- 0AAAf l7 <br />_ i] Unit 3 <br />�Nt <br />til __ <br />Ej"Unit 4 <br />4. <br />5. <br />6750 <br />7100 <br />$ Stockton (unincorporated) <br />S -Lounge --Street Lc vi e- Stockton (unincorporated) <br />6. <br />7199 <br />S-Eettnge-Street W�`-� <br />_ <br />Stockton (unincorporated) <br />7. <br />7679SLot3n' <br />�Sf`eet� wncl-e, <br />Lockheed Court <br />Stockton (Unincorporated) <br />Stockton (unincorporated) <br />ok"A VP � ❑ Unit s <br />8. <br />1888 _ <br />9. <br />6250 <br />Lindbergh Street <br />Stockton (unincorporated) <br />l ' I <br />Lj Unit e <br />10. <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ® MEDICAL WASTE FACILITY SOLID WASTE FACiLITYNEHICLE <br />❑C OTHER CLEANUP SITE (NON -LOP) ❑ MOUSING ABATEMENT WA5TE TIRE <br />® UNDERGROUND, TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br />ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL WASTEWATER TREATMENT PLANT <br />© HAZARDOUSWASTEMA7ARDOUS MATERIALS ❑ MOTFIIHOTEL ❑ PUMPER TRUCKIYARDICHEMICALTOILETS <br />® TIERED PERMITTED FACILITY ❑ POCLISPA ❑ LANE) USE APPLICATION SITES <br />❑ TATTOOIBODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 At4-5:00pM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses In the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax Lo (209) 464-013$ or mail to the address indicated abovg- Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. 'The EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br />should be scheduled accordingly. <br />3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br />submitted when the file Is available. <br />4. Any flle not returned In the same condition as released will be reorganized by EHD staff at therr expanse o_f the aplicant. <br />Future file revievis by the same applicant may require a $125 deposit prior to review. -' <br />914192 <br />TO/TO 39Nd S1NV1-1n5N05T_iV FRR99V/q7.R FG:TT GTR7./tin/9R <br />1— <br />